Myron David Koris, M.D.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

ME29028 Issued in FL

Practice address

4651 N State Road 7
#9
Coconut Creek, FL 33073-4378

Phone

(954) 753-4248

NPI assigned

Feb 25, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235692800000",
    "number": "1679713069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 HARBOR DR APT 1403",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162459",
            "telephone_number": "954-764-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 N STATE ROAD 7",
            "address_2": "#9",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734378",
            "telephone_number": "954-753-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORIS",
        "first_name": "MYRON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME29028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Knight, LCSW
• Tracie Nicole Knowles
• Ko Orthotics Inc
• Elisha Deborah Koota, A.P.
• Paul C Kopp
• Jeffrey Warren Kotter, CRTT
• Morgan Kramer, MS
• Anisa Kristollari, OPTOMETRY DOCTOR
• Amy Cheryl Krostich, CPNP
• Jeffrey M Kupiec, RPH

• Pain Medicine Physician in Coconut Creek, FL
• Providers in Coconut Creek, FL by specialty
• Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.